Daugherty Agile Incubation Transforms Major PBM’s Pricing Proposals

Executive Summary

One of the largest pharmacy benefit management organizations in the United States needed help with pricing proposals, a business-critical feature that ensures profitability. We built a user interface to show pending approvals, as well as the number of lives that would be affected and how many prescriptions would be written as a result. Our success hinged on our expertise in Agile, as well as our ability to work with whichever frameworks the client wanted to use, to drive work at a high velocity and to train the client’s teams to take over the project long term. The client can now optimize prescription prices for affordability while maintaining profitability.

Pricing proposals are business-critical for pharmacy benefit management (PBM) organizations, as the proposals ensure profitability among pharmaceuticals. The profits empower them to offer low-cost prescriptions to customers. One of the largest PBMs in the United States trusted Daugherty to help them track pricing proposals.

The client was using email to send pricing proposals and wanted to streamline the approval process. Because multiple employees weighed in on the proposals, emails often spiderwebbed, and important information risked getting lost. It was difficult determining immediate details and statuses of pricings without having to sift through multiple emails, and resulted in inaccurate underwriting estimates.

Taking the organization’s requirements, Daugherty determined the best solution: an application to show pending approvals, as well as the number of lives that would be affected, and how many prescriptions would be written as a result of these approvals.

The application also had a life-of-the-deal column to help pricers and approvers assess if the price was competitive enough to win a bid — across multiple years, too. The PBM could offer savings to customers and still be profitable.

We are Experts In Agile

Concurrent with this project, we were leading the client through an enterprise-wide Agile transformation, and this team was ahead by months. Daugherty proved we are a trusted Agile resource, offering the best Agile practices across whatever framework has the potential to be the most effective (in this case, Scrum). We leveraged Agile accelerators, including informal Agile coaching across teams at geographic sites.

We Share Knowledge

Daugherty collaborated with a number of employees at the organization, teaching them the code for the application, as well as what it’s like to develop in a Scrum team and how they could support the application long term. Not only were we able to deliver an optimal solution, we took the time to train their staff during the process.

We Look at the Whole Picture

When we work with our clients, we don’t just parachute in for a project, then zip out. We look at the whole picture as a trusted advisor. We’d already led this organization through a DevOps transformation, in which we’d helped to automate baseline tests to increase stability across more than 60 applications, many of which were dependent upon each other.

By working with Daugherty, the client has a single, centralized source of truth that provides data integrity and security, ensures transparency in the pricing approval process and ensures compliance to regulations.